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STATUTORY WAIVER AND RELEASE OF <br />LIEN UPON FINAL PAYMENT <br />(SECTION 713.20(5) FLORIDA STATUTES) <br />The undersigned lienor, in consideration of the final payment in the amount of $19,450.00 hereby <br />waives and releases its lien and right to claim a lien ,for labor, services or materials furnished to Indian River <br />County Utilities on the job of the Hobart RO WTP —Bulk Chemical Tank Replacements Project to the <br />following described property: <br />Job Owner: Indian River County Utilities <br />Job Name: Hobart RO WTP — Bulk Chemical Tank Replacements Project <br />Job Address: 7751 58th Ave, Vero Beach, FL 32967 <br />Date: J V 111i F— , 2021. <br />Lienor'sName: Le\wt2sr�iGE: LIEF= C0„4ST(ZvcT.0114 104. <br />Address: 000 SE Ltgco�N ASE. <br />Signature: <br />Name & Title: <br />STA iLT r FI_ -34-1-1,A <br />��F,oF�ry l;. Sca�D J. <br />.%`GO�S?RUCK/ <br />L'J: S.E . <br />d' 2017 •� <br />...i' • ... <br />EZF•SIpENT <br />Notary: State of Fua %DN County of 0 Aar"s <br />Notary Public state of FloBda Subscribed and sworn to before me this day of wit �O Z <br />+� Mark Richard Stahl <br />My Commission GG 319841 <br />a ry Expires 04r04/2o23 <br />Signature: Date: Ob off 2021 <br />Expires:. off o i Zoz <br />NOTE. This is a statutory form prescribed by Section 713.20, Florida Statutes. <br />A person may not require a lienor to furnish a waiver or release of lien <br />that is different from the statutory form. <br />70 <br />